Melasma is an acquired hypermelanosis skin disorder that commonly affects women than men. It is characterized by irregular light to dark brown macules occurring in the sun-exposed areas of the face, neck and arms.
It occurs most commonly with pregnancy and with the use of contraceptive pills.
Other factors implicated in the etiopathogenesis are photosensitizing medications, mild ovarian or thyroid dysfunction and certain cosmetics.
Solar and ultraviolet exposure is the most common important factor in its development.
Taking the oral extract product of the fern Polypodium leucotomos (PLE) on top of the standard topical hydroquinone cream and sunscreen reduces the severity of melasma to a greater extent compared with the standard treatment alone in Asian patients, a pilot study has shown.
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.